title: Weight, inflammation, cancer-related symptoms and health related quality of life among breast cancer survivors.
abstract: Maintaining weight is important for better prognosis of breast cancer survivors. The associations between weight and cancer-related symptoms are not known. We examined associations among weight, weight change, inflammation, cancer-related symptoms, and health-related quality of life (HRQOL) in a cohort of stage 0-IIIA breast cancer survivors. Participants were recruited on average 6 months (2–12 months) after diagnosis. Height, weight, and C-reactive protein (CRP) were assessed at approximately 30 months post-diagnosis; cancer-related symptoms (chest wall and arm symptoms, vasomotor symptoms, urinary incontinence, vaginal symptoms, cognition/mood problems, sleep, sexual interest/function), and HRQOL (SF-36) were assessed at approximately 40 months post-diagnosis. Weight was measured at baseline in a subset. Data on 661 participants were evaluable for body mass index (BMI); 483 were evaluable for weight change. We assessed associations between BMI (<25.0, 25.0–29.9, ≥30.0 kg/m2), post-diagnosis weight change (lost ≥5 %, weight change <5 %, gained ≥5 %), and CRP (tertile) with cancer-related symptoms and HRQOL using analysis of covariance. Higher symptoms scores indicate more frequent or severe symptoms. Higher HRQOL scores indicate better HRQOL. Compared with those with BMI <25 kg/m2, women with BMI ≥30 kg/m2 had the following scores: increased for arm symptoms (+25.0 %), urinary incontinence (+40.0 %), tendency to nap (+18.9 %), and poorer physical functioning (−15.6 %, all p < 0.05). Obese women had lower scores in trouble falling asleep (−9.9 %; p < 0.05). Compared with weight change <5 %, participants with ≥5 % weight gain had lower scores in physical functioning (−7.2 %), role-physical (−15.5 %) and vitality (−11.2 %), and those with weight loss ≥5 % had lower chest wall (−33.0 %) and arm symptom scores (−35.5 %, all p < 0.05). Increasing CRP tertile was associated with worse scores for chest wall symptoms, urinary incontinence, physical functioning, role-physical, vitality and physical component summary scores (all P trend < 0.05). Future studies should examine whether interventions to maintain a healthy weight and reduce inflammation could alleviate cancer-related symptoms and improve HRQOL.
authors.affiliation: Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: Ikuyo
authors.initials: I
authors.lastname: Imayama
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Alfano
authors.forename: Marian L
authors.initials: ML
authors.lastname: Neuhouser
authors.forename: Stephanie M
authors.initials: SM
authors.lastname: George
authors.forename: Ashley
authors.initials: A
authors.lastname: Wilder Smith
authors.forename: Richard N
authors.initials: RN
authors.lastname: Baumgartner
authors.forename: Kathy B
authors.initials: KB
authors.lastname: Baumgartner
authors.forename: Leslie
authors.initials: L
authors.lastname: Bernstein
authors.forename: Ching-Yun
authors.initials: CY
authors.lastname: Wang
authors.forename: Catherine
authors.initials: C
authors.lastname: Duggan
authors.forename: Rachel
authors.initials: R
authors.lastname: Ballard-Barbash
authors.forename: Anne
authors.initials: A
authors.lastname: McTiernan
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D001835:Body Weight; D001943:Breast Neoplasms / Q000150:complications* / Q000209:etiology; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D006304:Health Status; D006801:Humans; D007249:Inflammation / Q000209:etiology*; D008875:Middle Aged; D009765:Obesity / Q000209:etiology; D011788:Quality of Life; D017741:Survivors; D014549:Urinary Incontinence / Q000209:etiology; D015431:Weight Loss
chemical_list: D002097:C-Reactive Protein